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6. T/F:
a. Carotid atheromatous disease is the commonest cause
of strokes in the western world
b. Varicose veins are treated by femoral-popliteal bypass graft
c. Chest pain is relieved by elevation of the foot
d. Diabetic patient presenting with an ischemic foot
may have an Ankle Brachial Pressure Index of 0.8
e. Cervical rib may present with wasting of the thenar muscles
8. Hernias
a. Direct inguinal hernias pass through the internal ring
b. A femoral hernia is the most common hernia in females
c. Testicular atrophy may occur after inguinal hernia repair
d. Inguinal hernias in children are treated by herniorraphy
e. Open appendicectomy is associated with an increased
incidence of right sided indirect inguinal hernia
9. Pancreatitis
a. Cholelithiasis is the commonest cause
b. Cullens sign is associated with bruising in flanks
b. Steroids are not associated with acute pancreatitis
d. The treatment of sterile necrotizing pancreatitis in necrosectomy
e. A pseudocyst should be drained within 2 weeks of the acute attack
10. Gallstones
a. Ascending cholangitis requires emergency
decompression of the Common Bile Duct -
b. Choledochal cysts are associated with malignancy
c. The five year survival rate of adenocarcinoma of
gallbladder is less than 5% -
d. Magnetic Resonance Cholangiography gives an
accurate picture of the biliary tree
e. Gallstones can be dissolved by chenodoxycholic acid
13. Trauma/Cardiothoracic
a. In the initial management of the injured patient,
control of hemorrhage should be the priority
b. Right diaphragmatic rupture is more common than left
c. Fracture of left lower ribs may be associated with ruptured spleen
d. A flail chest is commonly associated with Acquired
Respiratory Distress Syndrome
e. Tension pneumothorax is diagnosed on chest X-ray
14. Urology
a. In suspected torsion of the testis, ultrasound may be of value
b. Unilateral orchidopexy is the treatment of choice
for torsion of the testis
c. Varicocele is more common on the right side -
d. Varicocele is associated with oligospermia
e. Uric acid calculi are the most common types of renal calculi
16. Melanoma
a. Ulceration of the primary lesion is associated with
worsening of prognosis
b. A brisk tumour infiltrating lymphocyte response is
associated with worse prognosis -
c. Clarks level III implies invasion of the reticular dermis
d. Suspicious lesions should be evaluated by initial incisional biopsy
e. Sentinel lymph node mapping should be considered
for lesions of intermediate depth (1-4 mm)
3. Regarding melanoma
a. Juvenile melanoma (Spitz naevus) is a benign condition
b. Breslow staging of <0.75mm has predicted 5 year survival of 95-100%
c. Acral lentiginous melanoma is the rarest form of melanoma
d. Overall males have a better prognosis
e. Locoregional radiotherapy confers a significant survival benefit
9. Toxic megacolon
a. Is unique to ulcerative colitis
b. Colonic perforation carries mortality of 50%
c. Is best treated with high dose corticosteroids for at least 72 hours
d. A gastrograffin enema may be diagnostic
e. Occurs in 10% IBD patients
3. Trauma
a. Pneumothorax can be temporarily treated by inserting a 16 gauge cannula in the second
intercostals space of the same side
b. Fracture of the posterior cranial fossa is associated with Battle ’s sign
c. Ultrasound is the gold standard in the diagnosis of rupture of the thoracic aorta
d. A flail chest is associated with pericardial effusion
e. Coronary air embolisation is an unusual consequence of injury to the lung parenchyma
4. Pharyngeal pouch
a. It is a pulsion diverticulum arising from Killians dehiscence
b. It appears as a swelling in the anterior triangle of the neck
c. Presents as halitosis, regurgitation of food and dysphagia
d. Is a congenital diverticulum
e. Arises withing the superior pharyngeal constrictor muscle
6. Nipple discharge
a. Bloody nipple discharge is due to fibrocystic disease
b. Serous discharge is due to duct papilloma in about of cases
c. Chromophobe adenoma is a microadenoma
d. Phenothiazines cause serous discharge
e. Treatment of bloody nipple discharge is microdochotomy
7. Thyroid gland
a. Graves disease is common in females
b. Subacute (DeQuervains) thyroiditis is an autoimmune disease
c. Papillary carcinoma, secondary to radiation, is multifocal
d. Men IIA comprises medullary carcinoma, phaeochromocytoma(s) and parathyroid
hyperplasia
e. Medullary carcinoma is treated by total thyroidectomy and central neck dissection
9. Crohn’s Disease
a. Is predominantly a transmural disease
b. Characteristic microscopic lesions are noncaseating granulomas
c. Bloody diarrhea is the most frequent presentation
d. Peri-anal disease is an infrequent presentation
e. Toxic dilatation of the colon is a common finding
10. Carcinoid tumour
a. The most common location of a carcinoid tumour is the terminal ileum
b. Appendiceal carcinoids frequently metastasise
c. Urinary 5-HIAA is the most reliable test to confirm the diagnosis of carcinoid tumour
d. Octreotide can successfully control the symptoms of diarrhea and flushing
e. 5-HIAA is a metabolite of tyrosine
11. Appendicitis
a. The commonest location of the appendix is in the pelvis
b. Psoas sign is elicited by flexion of the right hip
c. Is associated with a fecolith in 90% cases
d. Laparoscopic appendicectomy has been shown to be superior to open appendicectomy for
acute appendicitis
e. Rovsigns sign is elicited by pressing in the left iliac fossa causing pain in the right iliac fossa
13. Cholelithiasis
a. Biliary colic occurs only with stones in the common bile duct
b. Merrizi’s syndrome is associated with cholestatic jaundice
c. Charcot’s triad includes jaundice, rigors and palpable gallbladder
d. Chenodeoxycholic and ursodeoxycholic acid are used for dissolution of cholesterol
stones
e. For symptomatic cholelithiasis laparoscopic cholecystectomy is the operation of choice
14. Pancreatitis
a. Foxs sign is discoloration of groins
b. Alcohol is an aetiological factor for the development of acute pancreatitis
c. A Ransons criteria of 7-8 is associated with mortality of 50%
d. Steatorrhea is associated with acute pancreatitis
e. A chain of lake appearance is pathognomonic of chronic pancreatitis
15. Vascular
a. The mortality rate of ruptured AAA is 40%
b. Ultrasound can reliably meaure the size and site of AAA
c. Ruptured AAA may present as pain in the renal angle
d. Surgery is recommended for patients with AAA > 6cm diameter
e. Spinal cord ischemia is an infrequent complication
18. Orthopedics
a. Colles fracture results a fall on an outstretched hand with the wrist in flexion
b. Fractured ribs invariably cause a pneumothorax
c. The leg is externally rotated in fracture of neck of femur
d. Fracture of the humeral shaft may cause injury to the radial nerve
e. Fat embolism following multiple fractures is associated with petichial skin rash
19. Urology
a. The majority of bladder tumours are squamous cell carcinomas
b. Renal cell carcinoma is always treated with adjuvant chemotherapy
c. The most common urinary calculi are triple phosphate stones
d. Testicular tumours commonly metastasize to the groin lymph nodes
e. Fracture of the bony pelvis leads to injury to the membranous urethra
3. Salivary glands
a. Pleomorphic adenoma is the most common benign tumour of the submandibular gland
b. Mikulics Syndrome refers to the bilateral enlargement of lacrimal and salivary glands
c. Sialothiasis is almost exclusively a problem of the submandibular gland
d. Incisional biopsy is performed in all salivary gland tumours
e. Lingual nerve can be damaged in surgery on submandibular gland
4. Hernias
a. Direct inguinal hernias pass through internal ring
b. A femoral hernia is the most common hernia in females
c. Testicular atrophy may occur after inguinal hernia repair
d. Inguinal hernias in children are treated by hernioraphy
e. Littres hernia contains Meckels diverticulum
6. Vascular
a. Carotid atheromatous disease is the commonest cause of strokes in the western world
b. Varicose veins are treated by femoral-popliteal bypass graft
c. Rest pain is relieved by elevation of the foot
d. Normal ABI is greater than 0.90
e. Cervical rib may present with wasting of thenar muscles
7. Orthopedics
a. Smiths fracture results in volar angulation of the radius
b. A fractured neck of femur results in lateral rotation of the lower limbs
c. The radial nerve is injured in fracture of neck and humerus
d. Bennetts fracture involves distal end of radius
e. Supracondylar fracture may cause vascular complications
11. Pancreatitis
a. Cholelithiasis is the commonest cause
b. Cullens sign is associated with bruising in flanks
c. Steroids are not associated with acute pancreatitis
d. The treatment of sterile necrotizing pancreatitis is always surgery
e. A pseudocyst should be drained within 2 weeks of the acute attack
12. Gallstones
a. Ascending cholangitis requires emergency decompression of the CBD
b. Choledochal cysts are associated with malignancy
c. The five year survival rate of adenocarcinoma of GB is less than 5%
d. Magnetic resonance cholangiogram gives accurate picture of biliary tree
e. Gallstones can be dissolved by ursodeoxycholic acid
14. Trauma
a. In the initial management of the injured patient, control of hemorrhage should be the
priority
b. Right diaphragmatic rupture is more common than left
c. Fracture of left lower ribs may be associated with rupture of the spleen
d. A flail chest is commonly associated with ARDS
e. Liver or splenic injuries always require operative intervention
15. Thoracic/Neurosurgery
a. A chest drain is usually inserted in the 4th/5th intercostal space in the mid-axillary line
b. Thorascopic sympathectomy is the treatment of hyperhydrosis of the hands
c. CT scan of the brain is indicated in depressed skull fracture
d. A GCS < 8 is an indication for endotracheal intubation
e. Tension pneumothorax is diagnosed on chest X-ray
16. Endocrine
a. Follicular carcinoma of thyroid primarily spreads through lymphatics
b. Parathyroid adenoma is the most likely cause of hyperparathyroidism
c. Hurtle cell carcinoma is a variant of papillary carcinoma of the thyroid
d. Phaeochromocytoma is associated with MEN IIa
e. Superior laryngeal nerve supplies cricothyroid muscle
17. Paediatrics
a. Hydrocele in a child <1 year old necessitates surgery
b. Pyloric stenosis presents within 10-12 weeks of life
c. Mesenteric adenitis is an uncommon cause of abdominal pain in children
d. An undescended testes may be found in the hilum of the spleen
e. Children with pyloric stenosis have hypokalemic, hyperchloremic acidosis
8. Brachial embolism
a. Has more favorable prognosis than popliteal aneurysm
b May be operated upon under local anesthesia
c. Is associated with mitral stenosis
d. Always leads to gangrene is not removed
e. Embolectomy should be associated with fibrinolytic
therapy
9. Oophrectomy for breast cancer
a. Has now been abandoned as a form of therapy
b. Is best done by irradiation of ovaries
c. Has been replaced by
d. May reveal ovarian metastases
e. Should be followed by estrogen therapy if done at menopause
34. Nephroblastomas:
a. is radio-sensitive
b. Requires early surgery
c. Responds to chemotherapy
d. Has a good prognosis over the age of ten
e. Usually metastasizes to bone